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General NPI Number Information
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NPI Number | 1942893649
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Entity Type | Individual
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Provider Name | RYAN GREGORY NEES CADAC II
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Gender | Male
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Dates
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Enumeration Date | 02/15/2021
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 676 E SPRINGHILL DR
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City | TERRE HAUTE
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State | IN
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Zip | 47802-6804
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Country | US
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Telephone | 812-201-3269
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Fax |
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Provider Business Mailing Address
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Address Line | 330 E BLAINE ST
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City | BRAZIL
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State | IN
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Zip | 47834-2222
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Country | US
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Telephone | 812-201-3269
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C2-5162
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License Number State | IN
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